Non-invasive assessment of temporal changes in myocardial microvascular function in persons with type 2 diabetes and healthy controls.

Autor: Rasmussen IKB; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Hasbak P; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Denmark., von Scholten BJ; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Laursen JC; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Zobel EH; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Jorge Diaz L; Steno Diabetes Center Copenhagen, Copenhagen, Denmark., Holmvang L; Department of Cardiology, Rigshospitalet, Denmark., Ripa RS; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Denmark., Rossing P; Steno Diabetes Center Copenhagen, Copenhagen, Denmark.; University of Copenhagen, Copenhagen, Denmark., Kjaer A; Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Denmark.; University of Copenhagen, Copenhagen, Denmark., Hansen TW; Steno Diabetes Center Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2021 Jun; Vol. 38 (6), pp. e14517. Date of Electronic Publication: 2021 Jan 25.
DOI: 10.1111/dme.14517
Abstrakt: Background: Cardiac Rubidium-82 ( 82 Rb) positron emission tomography/computed tomography (PET/CT) provides a measure of the myocardial blood flow and the myocardial flow reserve, which reflects the function of both large epicardial arteries and the myocardial microcirculation. Knowledge on changes in the myocardial microvascular function over time is lacking.
Methods: In this cohort study, we recruited 60 persons with type 2 diabetes and 30 non-diabetic controls, in 2013; all free of overt cardiovascular disease. All underwent a cardiac 82 Rb PET/CT scan. In 2019, all survivors (n = 82) were invited for a repeated cardiac 82 Rb PET/CT scan using the same protocol, and 29 with type 2 diabetes and 19 controls participated.
Results: Median duration between visits was 6.2 years (IQR: 6.1-6.3). In the total cohort, the mean age was 66.4 years (SD: 9.3) and 33% were females. The myocardial flow reserve was lower in persons with type 2 diabetes compared to controls (p = 0.002) but there was no temporal change in the myocardial flow reserve in participants with type 2 diabetes: mean change: -0.22 (95% CI: -0.47 to 0.02) nor in controls: -0.12 (-0.49 to 0.25) or when comparing type 2 diabetes to controls: mean difference: -0.10 (95% CI: -0.52 to 0.31). The temporal reduction in stress-induced myocardial blood flow did not differ within the groups but was more pronounced in type 2 diabetes compared to controls: mean difference: -0.30 (95% CI: -0.55 to -0.04).
Conclusion: The myocardial microvascular function was impaired in persons with type 2 diabetes compared to controls but did not change significantly in either of the groups when evaluated over 6 years.
(© 2021 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)
Databáze: MEDLINE
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